Tiruvonam Rice & Food Products

Dealer Application Form

* Fields are mandatory

Name of the Firm*:

Full Address*:

Telephone:

Mobile:

Fax:

Email*:

Type of Firm:

Full Address of Partner/Prop:

Year of Establishment:

Bankers Name & Address:

Type of A/c(Facilities):

Turn over last financial year:

Contact Person for Communication with address and tel. nos.:

Sales Tax Details

Central Reg No:

State Reg. No.:

Ware House Facility (Area):

Address of Ware house:

Total Staff

Office:

Field:

Product Dealt at Present:

No.of Vehicles available(mention tonnage of vehicles):

Route Plan:

Enter Code (Case sensitive) *

Manufactured by : Popular Food Products,Tiruvonam Rice, Okkal P.O,Perumbavoor
Ernakulam.Pin-683550, Ph: +91 7034200200, +91 80 86 071 141 - 42